Post covid mitochondrial symptoms

Recovering From Post-Covid Mitochondrial Dysfunction

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Post-Covid Neurological Symptoms

After contracting Covid-19 in August 2020, I developed a post-Covid syndrome with gradually increasing neurological manifestations. It took several months to turn into something that could be called a serious neurological condition without an evident cause.

I had a relatively mild form of Covid-19. I never had any chronic diseases that I was aware of, and I was a happy and energetic man in my late thirties. However, Covid changed that abruptly. Shortly after I was discharged from the hospital, I began to experience shortness of breath. It wasn’t happening all the time but was noticeable during physical loads and periodically at night when I was trying to get some sleep. During these episodes, I measured my oxygen saturation and it always was 99%. So, no reason to worry, right?

After the shortness of breath, I developed a form of a sore throat that was aggravated during the episodes of shortness of breath. I did not draw a link between the two at first, but consequent observations proved they were linked somehow. I was also fatigued and the fatigue lingered. I had an intellectually demanding job but could not work full time anymore. Five hours out of 8 were somewhat achievable but anything longer than that was problematic. I developed mild hypothermia as well. Instead of a normal temperature of 97.9 °F (36.6 °C) I always had 95.9 °F (35.5 °C). Finally, I also experienced intermittent episodes of slight tinnitus in the left ear.

I truly hoped these symptoms would be improved over time, but that did not happen. Moreover, in December 2020, four months after recovering from an initial infection, I began to experience what I can only describe as short and intermittent “halts” of consciousness. These episodes happened during work, especially when I was concentrating on a challenging task. The “halts” were like 1-2 seconds of fear that I was losing control over my body and was going to die. They happened every few minutes. If I relaxed a bit and moved away from the challenging task, the “halt” symptom weakened and disappeared.

In January 2021, I started to feel awkward. It was an unexplainable doom and gloom feeling of imminent death in the near future that was haunting me everywhere. I began to feel burning sensations in my right foot and right hand and my sore throat was becoming worse.

New Onset Panic Attacks

Meanwhile, I remained a big fan of walking and walked up to 8 miles (13 km) a day. After one such walk in February 2021, I experienced the first panic attack in my life. My heart rate went crazy and the shortness of breath reached its new maximum by turning into suffocation. I was thinking I was going to die and called the emergency.

I took every blood test I could imagine and visited every doctor I could reach. I went to a cardiologist, neurologist, endocrinologist, and phlebologist. Every test was negative. I was declared healthy except for a few seemingly unrelated things. I had a mild form of T2DM with A1C of 6.7 and insulin resistance with HOMA-IR of 7.8. My low-density lipoprotein levels were slightly elevated. An interesting observation is that I took blood tests right before the acute phase of Covid, and I had no T2DM back then. During a talk with an experienced endocrinologist, I was told that those relatively moderate levels of glucose in my blood could not wreak such havoc alone. It might be something else, but nobody knew what it was. A neurologist concluded that it was just severe depression and suggested taking some antidepressants, which I did without any positive results.

Meanwhile, my panic attacks intensified. The sore throat gradually transformed into dysphagia. The burning sensation in my right foot and hand took over the whole right side of my body. I started to lose the ability to speak fluently, and I started to have problems with my gait and street navigation.

At the height of a panic attack, I felt that my intrinsic biological processes were stopping and that one day it may have an ultimate ending. I started to develop a condition called intestinal ataxia. My right hand now had neurological edema. My peripheral neuropathy worsened significantly and became seriously painful. Everything went downhill very quickly, in a matter of weeks and days. At the beginning of April 2021, I faced an immediate risk of becoming an invalid and thought I might die.

The bitter part of the story is that nobody was going to help me. All the doctors I had met were helpless.

Strange Observations

I started to observe strange things while I was suffering from the condition. First, my symptoms slightly improved after consuming specific foods. For instance, it happened every time I ate a burger with real beef. The positive effect persisted for 2 or 3 days and then vanished. The same improvement I’ve experienced from consuming a glass of milk, but the effect was way shorter lasting just one day. Second, the condition was greatly improved on days when I consumed NSAIDs such as Aspirin or Ibuprofen for an unrelated reason. Third, I felt almost healthy on the rare days when I ate those specific foods and consumed NSAIDs together by pure coincidence. Unfortunately, I did not draw any specific conclusions back then. Such correlations just looked a bit weird to me as I never experienced anything like that in my whole prior life.

Discovering Poor Brain Glucose Metabolism

While the condition was gradually worsening, I measured my blood glucose levels several times a day. One day I decided to conduct an experiment to find out how blood glucose levels are affected by walking. I started by measuring my base glucose level in the morning which then was 126 mg/dL (7 mmol/L). Then, without eating anything, I decided to take an 8-mile (13 km) walk. To my amusement, the glucose level fell to 81 mg/DL (4.5 mmol/L) at the end of the route. Everything worked as expected, it seemed that I was not that insulin resistant after all.

But what about mental and intellectual activities? It would be a nice experiment to conduct too. The next morning, without eating anything, I went to my job with a glucometer and measured the base glucose level which was 117 mg/dL (6.5 mmol/L) at the time. Then I started to work taking the most challenging tasks. After 3 hours of intensive intellectual work, I started to experience the aforementioned “halts” of consciousness. Time to measure the glucose level. It was 115 mg/dL (6.4 mmol/L). Wait, what? How is that possible after all these intellectual activities? Yes, there is a process called gluconeogenesis that could raise the glucose level but still, I did not expect such a high value after such a massive cognitive load on an empty stomach. Clearly, something was going wrong with my brain as it had significant problems with glucose utilization. This was the crucial moment. A simple scientific experiment allowed me to see the light at the end of the tunnel. The cells of my nervous system were unable to consume the usual levels of glucose as they were insulin resistant, and I just proved that with my measurements.

Was I Deficient In Thiamine?

A quick web search of such a metabolic condition resulted in thiamine deficiency (vitamin B1) and beriberi as possible culprits. I knew about beriberi, but it never bugged my mind to link it with my own condition. I always thought it could be only caused by extreme malnutrition, which was not the case with me.

Going deeper on that route, I found the work of Hans Krebs, who described the process of cellular respiration and received the Nobel Prize for it in 1953. I was amused. Not only did it explain everything I had experienced, but now I had some actionable plan to try and improve my health.

If the usual levels of glucose cannot be consumed by the cells due to their insulin resistance, does it mean that by artificially raising glucose concentrations in the blood we can stop a metabolic panic attack? I conducted the experiment on several panic attacks of mine and received a positive answer. Yes, a metabolic panic attack can be stopped or at least significantly decreased by consuming 15 g of sugar. I immediately started to practice that to save my cells from further damage whenever a panic attack was mounting. That knowledge improved my condition a bit and gave me some time to find the appropriate therapeutic dose of thiamine.

Would thiamine help to reverse insulin resistance? I went to the pharmacy and bought Benfotiamine. It was hard to find, but luckily it was provisioned in two pharmacies in my hometown, so I did not have to wait for too long. Being in serious neurological suffering and pain, I immediately consumed 150 mg of Benfotiamine. Instinctively, I expected some kind of reaction, so I consumed the dose gradually. No reactions developed, but I immediately felt better in just 15 minutes after taking the pill. After that experience, I understood that I will be able to survive.

Given this experience and research, I wondered if the cellular damage would be reversed completely. It was an open question. Benfotiamine made me feel better, but I still experienced polyneuropathy and shortness of breath. The panic attacks went away completely, however.

Are Vitamins the Answer to Post-Covid Symptoms?

The new knowledge explained a lot of strange things that were happening with my body. Remember I talked about strange unexplained positive effects of consuming meat and milk? Now it became clear why: those foods contain nutrients including a rich set of vitamins and minerals. Vitamins help the mitochondria to process the substrates (glucose and lipids) to produce the energy (ATP) that powers up the cells.

It also explained the strange positive effects of consuming NSAIDs. As it turned out, this is relatively well known too. The mitochondrial dysfunction causes an auto-immune reaction of the body to its own metabolically subpar cells. This inflammation does more damage than good in that situation: the vessels’ endothelium gets damaged, leading to various blood flow problems including micro-clotting.  This further aggravates the tissue hypoxia and makes the mitochondrial dysfunction even more severe in the affected areas, leading to even more inflammation. This is a self-fueling pathological process with a positive feedback loop.

An acquired mitochondrial dysfunction can be reversed to some degree by using supplementary vitamins, co-factors, minerals, and antioxidants. Thiamine takes one of the instrumental roles in this process as it catalyzes the reactions at the very start of the oxidative phosphorylation pathway, but thiamine alone may not do much unless a full spectrum of nutrients is supplied. Glucose is not the only fuel a mitochondrion can consume, and other pathways need attention as well.

Combining all these pieces and using the protocol for treating beriberi as the basis, I came up with an experimental therapy, which I first tested on myself. It consisted of B1, B3, B7, B2, multivitamin, magnesium, potassium, CoQ10, alpha-lipoic acid, resveratrol, L-carnitine, zinc, cuprum, and aspirin in certain forms and proportions. Going beyond medicals, it also included dietary corrections (ketogenic non-vegetarian diet, no tea, no coffee, and no alcohol) and mild physical activities (walking).

To my surprise and amusement, it gave the desired results. I was able to get rid of the panic attacks, hypertension, tachycardia, neurological edema, tinnitus, insulin resistance, dysphagia, cognitive impairment, fatigue, and neuropathy. It took some time and effort. One part of that was my own body that needed the time to adapt and heal, another part was numerous therapy refinements.

At the beginning of the therapy, I took frequent blood tests to ensure the right therapeutic direction. All my outstanding markers were gradually normalizing, proving that I was on the right track.

At the time, I was not aware of Drs. Lonsdale and Chandler Marrs’ work or Elliot Overton’s videos. You can imagine the level of my sheer astonishment when I compared my humble findings to theirs. Now, almost two years after the disease’s inception, I can call myself a healthy man, again.

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Photo by Marjan Blan | @marjanblan on Unsplash.

This story was published originally on August 11, 2022. 

19 Comments

  1. Hi Joel! How were you able to titrate to 300mg ttfd and 900mg Benfo in 3 months? Can you share any tricks? Also, can you let us know what other supplements (with dosage) that you used?

  2. Hi Alex.

    Thanks for sharing your story.
    I was completely blow away when I read it because your experience is identical to mine. I’ve been experiencing everything you have, even in the same order. I’m a 38 year old guy, living an active lifestyle and would consider myself pretty healthy. My problems also started after Covid in 2020. Tinnitus in my left ear, peripheral neuropathy in my right leg and arm, panic attacks and anxiety, sense of impending doom, gait issues, gut motility issues.

    I unfortunately did not figure it out as quickly as you did and how could I, every doctor I have ever visited during these years have told me I’m fine and “it’s all in your head”. I have had MRIs of my brain and upper back done to make sure it wasn’t anything sinister like MS, I’ve been to neurologists, rheumatologists, pain specialists, I’ve had liters of blood drawn, tested for every disease known to man and not once did any doctor think about nutritional deficiencies.

    Last year everything really took a turn for the worse. I developed POTS. My blood pressure went from pretty high (150/100) to extremely low (90/60) seemingly over night. My tinnitus became a constant pulsating tinnitus. I developed glossitis/geographical tongue with an intense burning feeling. I was experiencing ataxia in the right leg and edema that came and went in my right ankle. I even got a bakers cyst in my the back of my knee. I started having a really bad reflux problem and lots of dry heaving that came out of nowhere. I also got a retinal hemorrhage in the back of my right eye and peripheral which nearly cost me my eyesight. I’m still getting monthly injections to stabilize it and to reduce the swelling.

    In the midst of my declining health and the slew of new symptoms the eye was the thing that lead me on the right path. I made one more lap through the medical system assessing my new symptoms and nothing wrong could be found. They decided to treat all my symptoms separately like they always do. Not once did they suspect that there was a correlation to be found.

    I started doing research on macula degeneration and retinal hemorrhage and found an article about thiamine deficiency. Retinal hemorrhage due to B1 deficiency is apparently seen frequently in bariatric patients due to malnutrition.
    I started to read everything about B1 that I could get my hands on and learned about Beriberi. Everything made sense. Every single symptom I had could be explained by Beriberi. I later found Elliots YouTube channel and I binged every video he had on the subject.

    I started my vitamin protocol in the beginning of November last year and boy has it been a bumpy ride. The paradoxical symptoms came like a ton of bricks. I’m now crusing at 100mg TTFD and 300mg of Benfothiamine 3 times a day and I’m seeing improvement daily. I’m also using magnesium, potassium and a methylated B-complex.

    • The neuropathy has improved greatly.
    • My blood pressure is now normal.
    • POTS pretty much gone.
    • My gut motility has improved.
    • My Anxiety completely disappeared.
    • Ataxia, edema in my leg gone.
    • Glossitis/Geographical tongue completely gone.
    • Doctors are actually seeing reduced swelling in my eye for the first time. I’m in remission and my eyesight is coming back.

    I’m doing really well and it feels amazing that I’ve stopped the decline of my health. The question still remained, how did I get to this point in the first place? Now with all the facts I’m actually amazed it didn’t happened sooner in my life. I said in the beginning that I had an active lifestyle and considered myself healthy. That wasn’t always the case. It all started as a child. I was one of those kids who hated everything you would consider normal food. I was basically brought up on pasta, sugar, white bread and soft drinks. I started drinking alcohol in my teens and kept that lifestyle into my early thirties. What made me quit was when I met my girlfriend. I didn’t completely quit drinking but I normalized it. I went from a functional alcoholic to taking a few beers on the weekend. I’ve also been a heavy coffee drinker and I kid you not, I started drinking coffee when I was 13 years old. When I’m having a stressful day I can easily drink 10 cups of coffee. Sugar, processed foods and carbs were a main staple in my diet for most of my life.

    Now with all the facts in hand I’m not surprised I developed Beriberi. It had been cocking beneath the surface my entire life and the Covid infection was the thing that pushed me over the edge, it didn’t matter that I had made a lifestyle change 2 years prior. Working out and eating slightly healthier did nothing to help my metabolically broken body.

    Once again, thank you for sharing your story. How are you doing these days? Have you any new insights, tips or findings you like to share?

  3. I have been trying to “diagnose” my husband’s symptoms for the past several months and believe they stem from a mitochonidial issue. He had the J and J vaccine in early 2021, and had Covid twice after – mild for him, but was left with brain fog and tinnitus which eventually resolved. The last bout was this past winter. Since mid July, he has progressively worsening brain fog, balance concerns, and muscle weakness, especially after working out which leaves him drained for several days after. All neuro tests/MRI are negative and bloodwork is normal. I finally convinced him to see a Functional Medicine doctor, but have yet to secure an appointment.

    I’m convinced the vaccines have done at least as much damage to people as the virus. I can even conclude that those who had the vaccine AND had the virus are worse off than those with natural immunity.

    Thoughts on this?

    • It’s not unheard that a vaccine can cause adverse side effects. While those reactions are rare, they do occur for all kind of vaccines, Covid is no exception.

      I had only one such case in my environment. It was caused by the P vaccine and led to symptoms resembling a mild form of fibromyalgia. All the symptoms were successfully resolved by a multivitamin in conjunction with a NSAID during a couple of weeks. The particular multivitamin contained 15 mg of thiamine HCL (B1), 50 mg of nicotinamide (B3), plus other vital vitamins and minerals. The NSAID was Aspirin 300 mg. Please note, that this is neither an evidence neither an actionable plan for such kind of situations, just a small hint that may be helpful to someone acting at their own risk.

  4. I was getting a few of these symptoms.. comes in bursts for me. I have a condition called pku meaning I can’t have milk or meat.. I am trying to sort myself out via peptides

    • Wow. So I went and bought these B vitamins at the shop just before. Took 4% of a vitamin b1 250 pill. No joke

      Holy moly…

      Nearly fainted!! Wow. For 30 mins battling to not sleep.

      Then now feel my cheeks burn as I am incredibly photosensitive… its doing something..

      I can breathe so good too right now.. like when I’ve taken NAC.. but now get histamine reaction to it.

      Wow.

      This is incredible

      Do I take the same amount tomorrow night?

      Do i try the other vitamin b pills I bought.

      I also had a 50mg coq10 pill 5 hours earlier

      • Brandon,

        > I can breathe so good too right now.. like when I’ve taken NAC

        If you have any observable improvements caused by vitamins or by antioxidants like NAC then it means that you probably have some mitochondrial situation going on.

        B1 vitamin is trickier though. A person may have both kind of reactions: improvement and even imaginary worsening. But the presence of a reaction to B1 is a good thing in any case. It means that the vitamin affects person’s metabolic pathways and if the person can feel it, it says a lot in favor of a possible metabolic deficiency the person may be suffering from.

        Healthy people don’t feel anything after vitamins intake, even in therapeutical doses. Maybe slightly more energetic sometimes and that’s it.

        > Do I take the same amount tomorrow night?

        I would suggest to temporarily lower it considering a strong reaction you’ve had. Start small and slow, then gradually increase it once you are familiar with the current dose. If a person ceases to follow this precaution he risks to destabilize himself.

        Using a magnesium together with B1 (taken simultaneously) helps to get rid of a paradoxical reaction faster.

        • You know what, I felt incredible that night. Like Euphoria, brain fog that I didnt realise I had, asthma where i’d never been able to breahte like that ever before… all my muscles were no longer tense.. was incredible.

          it only last a few hours, then within 2 weeks i was able to do full 250mg HCL Thimaine pills… nothing..
          I switched the B1 types, massive MASSIVE doses, nothing…

          however something worked so spectacualry initially, then not at all, I will never know. and so much like a miracle… strange.

          Though I have since found some doctor who reckons asthma is a brain issue, and from what I experienced that night 12 months ago… I’d say he’s correct.

          I witnessed what my body was capable of that night, just how to get it back?

          • This is a typical situation – initial improvements followed by plateau. There are numerous ways around that.

            First of all, pay attention to medications. B1 alone may not be enough, as it works best in combination with maintenance doses of other vitamins. Some of those vitamins may need therapeutical doses. This applies to: B2, B3, B7, B12. Without them, the usefulness of B1 may be limited.

            Aside medications, the most important one is everyday physical activities. Like walking for 1+ hour every day, at least 5 days of 7, every week. Mild physical activities like that should be accompanied by mild intellectual activities to keep your cognitive function at a satisfactory shape.

            Another aspect: a balance between work and life. Depending on a kind of job you have, do not overwork yourself. 8 hours of highly concentrated work a day may be already too much for recovery. 5 hours is a more approachable duration. Do not stay late at night, do not wake up too early without taking a good sleep everyday.

            This is what I call 33/33/33 rule: the treatment of a neurological condition is performed only 33% by medications, 33% by mild everyday activities, and 33% by keep a healthy work-life balance. If you only use only one aspect, say medications, you only have 33% chances of recovery. But if you use all the approaches combined, you get 99% chances of recovery.

            I think that the problem of plateau is worth a dedicated article. In my case, a full recovery took about 10 months, but initially I was in a really bad condition. Sometimes the situation was so dire, that I was sorry that I had not died a night before. I think that it gave me a deep sense of direction in terms of therapy. But if someone experiences only mild neurological symptoms, I imagine they often find themselves in a limbo without a proper sense of direction.

  5. Thank you for responding so quickly. I totally know what you mean by “head pressure”. I’ve never had migraines before COVID, so I guess that is what I’m trying to explain. Mine is permanently (sometimes mild and then moving to horrendous) on the left side of my head and face. I’m pretty excited to start this new journey as I think it might be the missing part of my journey!

  6. Amazing post! I’ve managed to treat my symptoms really with initial B vitamin treatment and then some microbiome work. However, I had no idea about B1, which hasn’t been a part of my protocol. Could you share whether you had migraine/head pressure episodes as part of your LC picture? If so, have these improved with this protocol?

    • I did not have specific migraine episodes, but the sensation of a head pressure was a common occurrence, especially during panic attacks when blood pressure was rising through the rough. It quickly normalized when I started the therapy. For example, I had blood pressure of 200/100 before the Benfotiamine, and 120/80 after just a few pills of it. The sensation of a head pressure went away completely.

  7. I addressed different symptoms with the appropriate forms of thiamine (vitamin B1). Peripheral neuropathy was addressed with benfotiamine, movement and spatial orientation disorders with sulbutiamine, cognitive impairment with allithiamine/TTFD. B1 HCL was used for the megadosing at the later stages of recovery. This means that regimen should be refined for each person depending on symptoms.

    Here is the outline of a therapy I used:

    1. Alpha-lipoic acid 120-200 mg + CoQ10 60 mg 30 minutes before the first meal, every day
    2. B1* >= 150 mg + multivitamin + magnesium** 100 mg, after the very first meal, every day
    3. B3 (nicotinamide riboside) 100 mg. some time later in the day on an empty stomach, every day for first 5 months
    4. B1* >= 150 mg + magnesium** 100 mg, after the second meal, every day
    5. Aspirin 300-500 mg, right after the last meal in the evening, every 3rd day
    6. Bonus multivitamin intake, every 4rd day or so for first 5 months

    This regimen brought the substantial initial improvement. B3 was specifically potent in eradicating the shortness of breath.

    * The best form of B1 is several forms combined together depending on symptoms.

    ** DO NOT use Magnesium Lactacte as it worsens the lactic acidosis with corresponding worsening of symptoms. Avoid Magnesium Oxide, it has poor bioavailability. Magnesium Taurate works best of all, Magnesium Glycinate is good too. Magnesium Citrate is ok.

    If you hit a paradoxical reaction even from the miniscule doses of Benfotiamine or Allithiamine/TTFD then start with 5 mg of B1 HCL, then gradually increase. Sulbutiamine usually do not cause paradoxical reactions at all, even when consumed at full/large doses.

    A note of caution: if you decide to use the presented therapy you are doing it at your own risk. Start with very small doses of everything, then increase gradually; otherwise you may hit a paradoxical reaction or cardiovascular instability.

  8. if you read our book, “Thiamine deficiency disease, dysautonomia and high calorie malnutrition” this post ceases to be a mystery. Get your doctor to read it.

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